The influence of sports on anxiety, depression, and perceived problem solving ability

Abstract

Objective: In this study we aimed to investigate the depression, anxiety, and perceived problem solving ability levels of sportmen who exercise regularly and to figure out if they differentiate from non-exercising population according to these variables. Methods: All participants were aged between 18 and 35. Two groups of participants were included as follows: 69 sportmen (35 team sportmen, 34 individual sportmen) who exercise regularly (at least 5 hours/week) and 26 controls who stated not to exercise regularly. All participants completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Problem Solving Inventory (PSI), and a sociodemographic form. Results: BAI scores of two sportmen groups were statistically lower than the controls'. The team sportmen in comparison with personal sportmen and controls had significantly lower scores in BDI and PSI. Discussion: Our findings reveal that sports participation in general has a positive effect on anxiety and team sports participation has a positive effect on depression and perceived problem solving ability in particular. (Anatolian Journal of Psychiatry 2010; 11:38-43)

Full text

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
The Influence of Sports on Anxiety, Depression, and Perceived
Problem Solving Ability*
Fatih CANAN1, Ahmet ATAOĞLU2
1 Resident M.D., Department of Psychiatry, Düzce University Medical School, Duzce, Turkey
2 Prof. Dr., Department of Psychiatry, Düzce University Medical School, Duzce, Turkey
Corresponding author:
Fatih CANAN
Düzce Üniversitesi Tıp Fakültesi, Psikiyatri AD,
Konuralp/ Düzce
Phone: +90380-5414107-3159
Fax: +90380-5415486
E-mail: fatihcanan@gmail.com
*This study was presented as a poster in 14th Social Psychiatry Congress.

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
The Influence of Sports on Anxiety, Depression, and Perceived Problem Solving Ability
ABSTRACT
Objective: In this study we aimed to investigate the depression, anxiety, and perceived problem solving
ability levels of sportmen who exercise regularly and to figure out if they differentiate from non-exercising
population according to these variables.
Methods: All participants were aged between 18 and 35. Two groups of participants were included as
follows: 69 sportmen (35 team sportmen, 34 individual sportmen) who exercise regularly (at least 5
hours/week) and 26 controls who stated not to exercise regularly. All participants completed the Beck
Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Problem Solving Inventory (PSI), and a
sociodemographic form.
Results: BAI scores of two sportmen groups were statistically lower than the controls’. The team
sportmen in comparison with personal sportmen and controls had significantly lower scores in BDI and
PSI.
Discussion: Our findings reveal that sports participation in general has a positive effect on anxiety and
team sports participation has a positive effect on depression and perceived problem solving ability in
particular.
Key Words: Anxiety, depression, problem solving, sports
INTRODUCTION

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
The influence of exercise on mental health has been examined by many researchers.1-3 Exercise
is suggested to improve mood by multiple physiological and biological mechanisms, such as alterations in
central monoamine activity,4 reduced activity of hypothalamo–pituitary–adrenocortical axis,5 and
increased secretion of beta endorphins6 as well as improved physical fitness.7,8 Psychological
mechanisms like enhanced self-esteem,8,9 distraction from negative thoughts,10,11 improved sleep12 and
adaptation to stres13 are also suggested. In their large scale study (5061 participants), Steptoe and
Butler14 have found that exercise was associated with decrease in emotional stres, excluding the effect of
social and health status.
The literature shows some promise for exercise as a treatment for anxiety disorders and for panic
disorder in particular. The activity may provide necessary exposure to these sensations so that patients
with panic disorder can begin to recover.15 Preliminary work16 on the relationship between exercise and
panic disorder showed that exercise outperformed placebo in reduction of panic disorder symptom and
approached the level of benefit offered by clomipramine. But other studies has provided equivocal results
showing a benefit from exercise training or improved fitness for anxiety17-19 although this may be as much
due to the difficulties associated with the measurement as lack of the effect.
Stephens20 summarised epidemiological evidence that showed a clear association between
activity and several indices of subjective well-being. Affective benefits are reported more likely to be
experienced if participants focus on personal improvement goals.21 A meta analysis which focused on the
relationship between fitness and cognitive performance in older adults showed a weak but significant
overall effect size. It appears that the view that exercise into old age keeps people alert and spritely has
yet to be substantiated fully.22 There are insufficient numbers of well conducted studies in younger adults
and children to draw conclusions. Exercise is reported to have no effect on the time it took to fall asleep
but it reduces rapid eye movements (REM) and increased the time before onset.23
Evidence is convincing that exercise can be useful in treating and avoiding depressive illnesses.
Regular exercise appears to offer a vehicle for more deep-seated change through improvements in the
way we view our physical selves and self-esteem.9 Any negative mental effects from exercise seem to
affect only a small percentage of participants.

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
In this study, we aimed to investigate some certain mental health outcomes of different types of
sports. Based on our literature research, this study is the first which investigates the relationship between
regular exercise and perceived problem solving ability.
MATERIALS AND METHODS
Procedure
All sportmen (n:69), who were included in the study were members of several sports clubs in
Duzce city. None of the sportmen had a diagnosis of physical and mental disorder and all were aged
between 18 and 35 years. The sportmen had to exercise regularly (at least 5 hours/week) in order to be
included to the study. The sportmen were divided into two groups as team sports participants (football,
basketball, and valleyball) and individual sports participants (athletics, boxing, taekwondo, and archery).
There were 35 volunteers in team sports group and 34 in individual sports group. For comparision, 27
healthy volunteer controls who stated not to exercise regularly, between the ages 18 and 35 were
included into the study as well. Participants in the control group were selected from the stand which was
established in Duzce city center. Volunteers were included if they had accepted to participate after being
informed. All participants were asked to complete Beck Depression Inventory (BDI), Beck Anxiety
Inventory (BAI), Problem Solving Inventory(PSI), and a sociodemographic form which was prepared by
the authors (First part of this form elicited information such as educational and occupational status and
second part assessed information such as duration of the sport which was completed solely by
sportmen). Written informed consent was obtained from each participant.
Data gathering tools
Problem solving inventory (PSI)
To assess problem-solving ability, the 32-item Problem Solving Inventory (PSI), developed by
Heppner and Petersen24 and adapted into Turkish by Şahin et al.25, was used. Participants assessed
each item on a 6-item Likert type scale (I always behave this way (1) and I never behave this way (6)).
Therefore, the possible total scale score ranges between 32 and 192. High scores from the scale show
that the subject does not trust his/her problem-solving ability. In the reliability and validity study conducted
with university students, Şahin et al. (1993) found the internal consistency of the scale to be 0.88, and

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
criterion-related validity coefficients for the PSI was found to be 0.33 and 0.45, by using the Beck
Depression Inventory and the State-Trait Anxiety Inventory, respectively
Beck Depression Inventory (BDI)
It measures the physical, emotional, and cognitive sypmtoms that are seen in depression. It is a
self-rating scale including 21 symptom categories. Depression was measured by using a Turkish version
of the Beck Depression Inventory (BDI et al., 1961), which consists of 21 items. Maximum total score is
63. Total score is positively correlated with depression severity. BDI has been developed ny Beck et al.26
and Turkish adaptation of the BDI had been done by Hisli.27
Beck Anxiety Inventory (BAI)
This scale evaluates the frequency of anxiety symptoms. It is a self assessing, Likert type scale
which is rated between 0-3 and includes 21 items. Total point increases with the severity of anxiety. It
was developed by Beck and colleagues.28 Validity and reliability of the Turkish form of the inventory was
performed by Ulusoy and colleagues.29
Statistical analysis
The statistical analysis was performed by SPSS, version 10.0. The following variables were not
normally distrubuted (Kolmogorov-Smirnoff test): age, time past in sports, and weekly exercise duration.
Spearman correlation was used to examine the relationship between these variables and mean inventory
scores. Parametric tests (t test or one way ANOVA as the most appropriate for related data) were
performed for normally distributed variables. Post hoc analysis with the Scheffe test was applied if
significant differences were found with analysis of variance. Chi-square tests were used to evaluate the
differences between groups for categorical variables.
RESULTS
The study consisted of 35 team sportmen, 34 individual sportmen, and 27 comparison subjects.
The mean age of the sportmen group was 23.5 (SD=2.7), and that of the comparison group was 23.8
(SD=4.4). No significant differences were found between the three groups with respect to
sociodemographic variables (Table 1).
Table 1. Sociodemographic characteristics of study groups.

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
Individual
sportmen
Team
sportmen Controls χ2 df p
Marital status
Single
30
27
19
6.785 6 >
0.05
Married
4
8
8
Gender
Female
11
7
6
1.558 2 >
0.05
Male
23
28
21
Duration of
education
5 years
5
5
7
3.049 2 >
0.05
8 years
5
6
8
11 years
19
18
7
13-15
years 5 6 5
TOTAL
34
35
27
The mean BAI scores of the control group were significantly higher than that of team sports and
individual sports groups. The mean BDI and PSI scores of team sportmen were significantly lower than
that of controls and individual sportmen. (Table 2)
Table 2. Mean inventory scores of study groups. (BAI: Beck Anxiety Inventory, BDI: Beck Depression
Inventory, PSI: Problem Solving Inventory)
Individual
sportmen Team sportmen Controls

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
Mean
SE
Mean
SE
Mean
SE
BAI
11.00
1.25
7.54
0.40
20.4*
2.12
BDI
12.02
0.88
7.00**
2.56
12.81
0.93
PSI
97.65
2.33
78.11**
1.69
91.44
2.35
* Significantly higher than other group (p<0.001).
** Significantly lower than other group (p<0.001).
The team sports group experienced more depressive and anxiety symptoms than the comparison
group according to mean BDI and BAI scores. Team sportmen trust their problem solving ability much
more than the individual sportmen and the controls.
There was no difference between genders according to BAI, BDI, and PSI scores. Age, and total
hours spent on exercise in a week were not correlated with inventory scores. Eleven of 69 sportmen (15.9
%) reported a history of sports related injury (fracture, dislocation, etc.) and these 11 sportmen’s mean
inventory scores did not differ from the other sportmen. Duration of sports participation was negatively
correlated with BAI, BDI, and PSI scores (p<0.05).
DISCUSSION
Several studies have researched the effect of sports on depression and anxiety, revealing
benefits of exercise.1-3 Physical inactivity may be related with occurance of some mental disorders. Some
clinica and epidemiological studies showed cross-sectional and prospective relationship between physical
activity and depression and anxiety symptoms.30-32
Regular exercise has been stated to decrease depressive symptoms in both clinical33,34 and non-
clinical35,36 population by a large number of studies. Strawbridge et al.37 have shown that sports
prevented depression in elderly adults. Similarly, Motl et al.32 have revealed that an increase in physical
activity was negatively correlated with depressive findings in early adolescent period.
After excluding the effect of age and gender has, Stepteoe et al.38 have found that sports had
decreased depression symptoms in their study involving 16,483 high school students. To the best of our
knowledge, present study is the firt to investigate the relationship between type of sports and depression

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
revealing that team sports was associated with a decrease in depressive symptoms. However this
relationship was not valid for individual sports.
In a study which was carried out in 15 countries of European Union, evaluating individuals over
the age of 15 with self-report instruments, sports has been found to affect mental health positively and
this effect was found to be related with the duration of the sports activity.31 In parallel with this finding, we
have found that as long as the duration of the sports activity increases, depression and anxiety symptoms
decrease. Moreover, a linear relationship has been found between the duration of sports activity
participation and perceived problem solving ability.
The effect of sports on anxiety disorders is a relatively under-investigated field, despite the
presence of several studies revealing beneficial effects of sports on depression. Some evidence exists
about anti-panic effect of acute exercise exposure in healthy individuals and in patients with panic
disorder, and sports may be used as an exposure therapy in panic disorder.39 Sports may also have a
symptom reducing role in post-traumatic stress disorder.40 In our study, anxiety levels of regular
exercisers were found to be significantly lower than that of non-exercisers regardless of the type of
sports.. This finding lends support for the beneficial effect of sports on anxiety treatment.
In our study, team sportmen had lower scores on PSI which means that they trust their problem
solving ability much more than individual sportmen and non-exercising population. This may be explained
by the educative aspect of team sports. Team sports may enhance organizing ability, positive interaction
capacity, and multi-aspect thinking.41 Unconforming behavior may cause the rejection of the individual
and this may create a “normalization process” which is a kind of benefit of group setting42 In addition,
individual desicions are perceived less reliable than the desicions made in a group setting.43
Sosyodemografik veri anketi ile katılımcılara daha önce psikiyatrik tanı alıp almadıkları
sorulmasına karşın yüz yüze görüşme ile ruhsal durum muayenesi yapılmamıştır. Çalışma sonuçlarını
etkileyebilecek diğer faktörler (aile tutumu, çevresel yapı, yetiştirilme tarzı, kişilik özellikleri, vs.)
değerlendirilememiştir.
Several limitations of this study should be noted. First, the number of the subjects were relatively
small to draw definite conclusions. We used self-reporting scales instead of face to face interview. other
factors that may affect study results such as family and trainer trait was not investigated.

Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.
By showing an important cross-sectional association of regular exercise (particularly with team
sports involvement) with anxiety, depression, and perceived problem solving ability, this study paves the
way for future investigation of the causal structure of the associations of team sports involvement with
perceived problem solving ability and depression and anxiety in broad samples.
Our study and results lead us to conclude that sports participation in general has a positive effect
on anxiety. While individual sports involvement is shown to have no effect on depression and perceived
problem solving ability, team sports involvement affects depression and perceived problem solving ability
positively. These findings may be a basis for encouraging people to participate in team sports for an
improvement in some certain aspects of mental health.
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Canan F, Ataoglu A. The influence of sports on anxiety, depression, and perceived problem solving ability. Anatolian Journal of
Psychiatry. 2010;11(1):38-43.